Managing menstrual migraines.

Managing menstrual migraines.

Menstrual Migraine: Taming the Monthly Beast

If you think migraines timed to your menstrual cycle are just something you have to suffer through month after month, think again. There are very useful treatments available that can make this a more comfortable time, according to Huma U. Sheikh, MD, a headache specialist and CEO of New York Neurology Medicine.

How can I tell if it’s menstrual migraine?

If your migraine starts anywhere from 2 days before your period to 3 days after, you have menstrual migraine. But you can also get migraines at other times, like when you’re ovulating. Menstrual migraine attacks tend to be more severe and last longer. And you’re typically more sensitive to light around this time than with other migraine attacks. Keeping a headache diary or using an app can be helpful in determining if there’s a clear pattern.

Why do I get a migraine during my period?

It’s all about hormones. During the course of a normal cycle, your estrogen levels rise until about day 14 of your cycle. That’s when you start to ovulate and make more progesterone. Around day 27 or 28, both hormones drop back down to a normal level. The sudden drop of estrogen can trigger a migraine headache for many women.

What helps with menstrual migraine?

There are lots of ways to manage and treat your menstrual migraines. These include mini-preventive treatment, acute treatment, and hormonal treatment.

Mini-preventive treatment

You can sometimes stop menstrual migraine attacks before they start or lessen how severe they are with prevention techniques. One option is taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or fenoprofen calcium (Nalfon) two times a day for 5-7 days. Another option is estrogen supplementation. You can use a pill, vaginal gel, or patch before and during your period to stop the natural estrogen dip that triggers a migraine. Other mini-prevention techniques include taking magnesium and triptan medication.

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Acute treatment

If you’re in the middle of a menstrual migraine attack, you can take medicine to ease the pain. Your doctor may recommend a fast-acting triptan or selective serotonin receptor agonist. Most triptans are pills, while some are available as injections or nasal sprays. CGRP antagonists are another option that block the effects of CGRP, a molecule involved in causing migraine pain.

Continuous prevention

If other methods don’t work or your period is irregular, your doctor may recommend continuous preventive treatment involving birth control pills or a vaginal ring without a monthly break. Changes in hormone levels or Botox injections can also help. Neuromodulation treatments, which send signals to your brain and nervous system, can be used during or to prevent an attack.

What should I avoid?

Avoid triggers or things that make your migraines worse. Common triggers include alcohol, dehydration, stress, heat, and light sensitivity. Try to drink enough water, avoid alcohol around your period, and spend time in cool, dark rooms if you have light sensitivity.

Can lifestyle choices help menstrual migraine?

Regular exercise, a healthy diet, and a consistent sleep schedule have been shown to reduce overall menstrual symptoms and can help with migraine attacks. Managing stress through relaxation techniques, yoga, and mindfulness can also regulate hormones and make this time easier.

Which menstrual migraine treatment is right for me?

It’s important to consult with your doctor to determine which treatment options are best for you. A combination of strategies, including mini-prevention, acute treatment, and lifestyle changes, may be recommended. Continuous birth control is also an option in some cases. Remember, taking an individualized approach is key since everyone’s experience is different.

Menstrual migraines don’t have to be an unavoidable monthly torment. With the right treatment approach and self-care practices, you can take control and minimize the impact of these migraines, making your menstrual cycle a more comfortable time to navigate.